By Joe Menard

Contributor

Changes in friends, physical appearance or sleeping or eating
patterns

Drop in grades or loss of interest in favorite activities

Kids and teens are getting high using a common over-the-counter
drug that can cause hallucinations and even death-and most are
getting it from their own family's medicine cabinet.

The high-inducing ingredient is called dextromethorphan, a cough
suppressant found in medicines such as NyQuil, Coricidin and
Robitussin, among scores of other non-prescription brands. When
taken as directed, dextromethorphan, also known as DXM, affects the
brain reflex that triggers coughing. But those abusing the drug
take up to 50 times the recommended dosage to achieve a high
similar to the dissociative, out-of-body experience from the drugs
PCP and Special K.

"It's not taking an extra teaspoon or a little too much. It's
taking 25 to 50 times the dosage to get the effects they are
looking for," says Cam Traut, a school nurse at Libertyville High
School. "If too much is taken, the side effects can be very, very
serious, if not fatal."

The drug has gained in popularity among teens because it is
easily available and doesn't carry the same stigma as illegal
street drugs. "It's out there and it is prominent and people need
to be aware of the risks," says Traut, a member of a coalition of
school nurses on a campaign to educate parents and educators on the
prevalence and risks associated with cough medicine abuse.

Home-grown danger

A little more than 5 percent of teens and young adults have used
non-prescription cough or cold medicines to get high at least once,
according to a U.S. government report published in 2008. The
report, the National Study on Drug Use & Health, also found
that more than half of the one million young people who had abused
cough or cold medicine in the last year were between 12 and 17
years old, and more girls than boys had reportedly done it.
Researchers polled nearly 45,000 people, age 12-25, for the study,
conducted in 2006 by the U.S. Department of Health and Human
Services' Substance Abuse & Mental Health Services
Administration.

"It's much more available to kids because you have it in your
house," says Tari Marshall, director of external affairs for
Prevention First, a non-profit resource center in Chicago
specializing in drug abuse prevention. She says teenagers view
over-the-counter drugs as safe because of their availability. Plus,
they remember mom administering doses to them as children.

"What they don't understand is it is only safe when taken as
directed. They think they can't overdose," she says.

They're wrong. The health risks of taking such high doses of
dextromethorphan are severe and potentially fatal, especially when
combined with alcohol, illicit drugs or other over-the-counter and
prescription drugs, health experts say.

Additional cough medicine ingredients commonly used, such as
acetaminophen and antihistamines, carry risks of their own when
taken in such high quantities, including severe liver toxicity and
breathing difficulties, says Dr. Karen Sheehan, director of the
Injury Prevention & Research Center at Children's Memorial
Hospital in Chicago.

"A lot of time kids are taking a bunch of different medicines
without really knowing what they're taking. And the amount they
take is so much greater than what is ever prescribed," Sheehan
says, noting the drugs can cause people to forget to breathe or to
choke on their own vomit. "It's very concerning. It just puts them
at a risk for, essentially, death."

Over the last decade, there have been several deaths across the
country connected with dextromethorphan. Experts say exact numbers
are extremely difficult to track because emergency rooms do not
test for it, and families often don't release cause-of-death
information in suspected DXM fatalities.

"This is a drug that emergency rooms will not even look for.
It's very hard to track it and get the exact figures. But we know
the risk is there," says Dr. Danesh Alam, medical director of
Behavioral Health Services at Central DuPage Hospital in
Winfield.

Alam, who runs the hospital's substance abuse program for
adolescents, has seen a steady number of patients come through the
program with a history of cough medicine abuse. He says kids often
take the drug in combination with other drugs, sometimes not
knowing what substances they were taking. At some parties, teens
will first raid their parents' medicine cabinets for anything they
think will offer a high and distribute the medicines to friends who
in turn share their stash. "Adolescents don't have a steady supply
of anything. They'll use whatever they can find."

Tests on rats showed DXM can cause changes in the brain that
control behavior and cognitive skills, and can lead to psychosis,
Alam says. It also is habit forming. "The treatment course is very
hard and challenging for this drug."

Parents are best prevention

The best tool for fighting the trend is being part of your
child's life and knowing what they do and who they do it with.

"(Parents) are the most powerful voice in their teen's life,"
Traut says.

She and other school nurses across the country are bringing
cough medicine and other over-the-counter medicine abuse to the
forefront with the Home to Homeroom campaign. Working with five
mothers who lost their children to non-prescription drug abuse, the
nurses hope to highlight the dangers and get parents and educators
to take the issue more seriously.

Experts also caution against assuming your kids are too young or
too naïve to experiment with drugs. "Too many parents don't realize
that kids as young as fifth and sixth grade are beginning to
experiment," Prevention First's Marshall says. "Don't make the
assumption that they don't already know about it. They're going to
find out about it at some point. Don't you want it to be from you
and not a friend who is going to glamorize it and make it sound
great?"

In addition to communicating, they also suggest hiding cough
medicine and any other medication from kids and teens. "This is one
area where prevention really works," says Alam, a psychologist.
"Number one, lock up all the drugs in the house. Be involved in
their lives. Be interested. Be familiar with what your child is
doing after school."

Chicago parent Curtis Gonzales decided to lock up all the cough
medicine in his house after he heard kids were using NyQuil to get
high. "That changed my view big time," says Gonzales, 33, whose son
Nicholas is a sophomore at Rickover Naval Academy on the city's
North Side. "I want to be the one to give it to him when he's
sick."

Prevention needs to be seen as an ongoing effort. "It's not one
conversation. It's a series of conversations that begins in and
continues through high school," Marshall says. "Parents have to let
their kids know that it's not OK to use drugs of any kind."